Ferritin
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a retired 58 year old construction worker with no significant complaints comes for a regular check
drinks a few beer bottles a week and has history of asbestos exposure
most likely malignancy that can develop
a)Ca Bladder
b)Bronchogenic Carcinoma
c)Lymphoma
d)malignant mesothilioma
e)scrotal carcinoma
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| DadooKhan
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D
But i'm torn between B -- I have a feeling mesothelioma is rarer complication. In any case -- mesothelioma has a biphasic pattern
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| maoudoody
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b.....bronchogenic is the most common in asbestos......mesothelioma is rare
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| keepgoing
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asbestose+smoke--1st primary lung ca and 2nd mesothilemia.
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| DadooKhan
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I knew it! but i still picked the wrong answer. 
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| maoudoody
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http://library.med.utah.edu/WebPath/LUNGHTML/LUNG...
"The risk factor for mesothelioma is asbestos exposure. However, mesothelioma is rare even in persons with asbestos exposure. Asbestosis more commonly predisposes to bronchogenic carcinomas, increasing the risk by a factor of five. Smoking increases the risk for lung cancer by a factor of ten. Thus, smokers with a history of asbestos exposure have a risk 50 fold greater likelihood of for developing lung cancer"
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| DadooKhan
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maoudoody wrote:
http://library.med.utah.edu/WebPath/LUNGHTML/LUNG081.html
"The risk factor for mesothelioma is asbestos exposure. However, mesothelioma is rare even in persons with asbestos exposure. Asbestosis more commonly predisposes to bronchogenic carcinomas, increasing the risk by a factor of five. Smoking increases the risk for lung cancer by a factor of ten. Thus, smokers with a history of asbestos exposure have a risk 50 fold greater likelihood of for developing lung cancer"
muchos gracias
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| alirizvi
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bronchogenic can be due to smoking also but mesothelioma is specific for it =)
IF u notice the advertisement on TV.. they always say that if u just retired from your job due to mesothelioma call the law office and we will get u $$ , but they never mention bronchogenic because then everyone will call.
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| SILVER
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B
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| GoodGirl
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I would go with D ( mesothelioma ) as asbest is the principal carcinoge in the pathogenesis of mesothelioma, and I think this would be most likely a malignancy he will develop.
If the question would mention he is a smoker, than I would go with B ( bronchogenic carcinoma ) , but it did not.
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| Karime
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d
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| alirizvi
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It is definately B.. i think it takes 20 yrs or something to get mesothelioma.. Guys i was saying mesothelioma is more specific for asbestosis, i was not saying that it is more common. I m srry if it came out wrong.
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| maoudoody
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goljan says 25-40 yrs to develop mesothelioma
this doesnot mean it will develop in all exposed patients to asbestos....it means the small number that will develop mesothelioma from those exposed to asbestos will do in 25-40yrs
the larger number definitely will develop bronch carcinoma
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| alirizvi
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yea its 20% of pts in 20yrs 
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| keepgoing
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he is not smoker,only asbestos exposure n alcohol,i think here is D,if was smoking plus asbestos then wud have been 1st pri.lung ca then meso.
ferritin what is the answer?
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| Ferritin
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right sorry i took longer guys
it's b)bronchogenic carcinoma
i picked mesothilioma as well
this is what kaplan q bank said slapping me on the face
"a little knowledge such as the "knee jerk" association betwen asbestos exposure and mesothelioma can get you into trouble on this type of USMLE question.Malignant mesothelioma is avery rare tumour associated with asbestos exposure.
Hoever brocho Ca is more common in asbestos exposure as well as the gerneral population.
Asbestos exposure is also associated with pulm interstitial fibrosis and pleural reactions"
the first line did slap me on the face though 
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| keepgoing
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I felt the warmth too 
thanks.
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| alirizvi
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Yea that is what i am saying malignant mesothelioma is specific for asbestosis but not most common. Like ketoacidosis is specific for diabetes type I but not all of them get it.
But just beause the patient has exposure doesnt mean he has the disease because it takes many years. In my exam the guy was smoker and brake pad worker and he was exposed but he had hilar mass and no pleural plaque.
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| Ferritin
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hey ali how was your exam ?why dont u regurgitate a few remembered things/questions from the exam..................thats my attempt to sound studious and totally into this once i say regurgitate!
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| GoodGirl
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Ferritin wrote:
hey ali how was your exam ?why dont u regurgitate a few remembered things/questions from the exam..................thats my attempt to sound studious and totally into this once i say regurgitate!
Check this out : http://www.prep4usmle.com/comments.php?id=78775&page=last#lastpost
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